Dianne Ditmer, RN, PhD, CFN, DABFN, CMI-III, CHS-III. SANE, FACFEI,
is a certified forensic nurse and clinical educator at Kettering Medical
Center in Dayton, Ohio. with a background in emergency nursing, risk and
management, medical error investigation. Dr. Ditmer is committed to
improving the quality of care provided to vulnerable populations and
victims of violence through education of multi-disciplinary
professionals. Dr. Ditmer was appointed to the Governor's Taskforce
on Child Abuse and Childhood Trauma. She collaborates with educators,
law enforcement, and legislative members to develop evidence-based
educational programs for school systems, healthcare providers, and
foster families. In addition to her role as an educator, Dr. Ditmer
provides direct care for living victims of abuse, neglect, and sexual
assault.

With 30 years of experience as an RN, Dr. Ditmer has worked as a
Nurse Resident in a Trauma Center for one year and has also been an
Emergency Department Nurse manager for 7 years and a Sexual Assualt
Nurse Examiner for 8 years. As a credentialed Fellow of the American
College of Forensic Examiners Institute (ACFEI) and Diplomate of the
American Board of Forensic Nursing (DABFN), she serves as chairman of
the American Board of Forensic Nursing and board member of the Ohio
Healthcare Taskforce on Family Violence. As a member of the Montgomery
County Sexual Assault Response Team and contributing author of the
Montgomery County Sexual Assault Protocol Manual. Dr. Ditmer
collaborates with members of law enforcement, coroner's office, and
the prosecutor's office. She has been an integral part of the
forensic nursing program as author of ACFEI's Intro to Forensic
Nursing course, and has seen the benefits of the certification
firsthand.

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What is the importance of forensic nursing and how did you first
become involved with the this program?

Six thousand acts of violence are committed every day across the
United States. Victims of rape, abuse, neglect, and trauma occupy beds
in our medical centers, clinics, and private practices. Victims are much
more than faceless numbers; they are our patients. They come to us with
acute injuries exacerbated by chronic illness and social issues. They
are physically fragile, emotionally devastated, and experience extreme
humiliation and denial. Nurses, by training and a commitment to
excellence, apply the foundations of physical, biological, psychosocial,
and spiritual aspects of man to the evidence-based investigation and
treatment of vulnerable populations. Forensic nurses are in a unique
position to make a difference in the lives of our patients through
prevention, community and family education, and early identification and
universal screenings. Multidisciplinary collaboration and intervention
through comprehensive utilization of community resources are
foundational to the health of our patients and the safety of our
society.

Awareness of the prevalence of violence and the opportunity to care
for victims launched my personal interest in developing focused
curriculum that would provide a broad-based introduction to forensic
nursing. Developing a program that allows nurses to investigate the
application of forensic principles and standards of care while
integrating this contemporary science into the nursing process will
result in better patient care and evidence-based practice.

How does forensic nursing as a specialty fit into the medical world
today?

Forensic nursing is the application of the nursing process to
medical and legal investigations. Nurses apply forensic aspects of
healthcare to the scientific investigation of trauma, abuse, violence,
death, and criminal activities related to medical-legal issues.

We care for vulnerable populations, both living and deceased, and
apply the foundations of physical, biological, psychosocial, and
spiritual aspects of academic training to the scientific investigation
and treatment of physical or emotional injuries. Based on the nursing
process, forensic nurses perform a thorough assessment, identify
injuries or wounds, and document our findings. The forensic nurse's
unique ability to obtain and document information ensures that evidence
is secured for further forensic analysis.

As advocates for our patients and advocates for the truth, forensic
nurses are healthcare's response to violence based on specialized
knowledge and clinical training to do the following:

* examine and care for individuals through the lifespan, including
victims and perpetrators.

* collaborate with multidisciplinary colleagues.

* offer consultative services to physicians and law enforcement
agencies.

* identify, collect, and preserve evidence.

* interface with the Judicial System by providing expert testimony.

How would you describe the role of the forensic nurse in the major
types of medical/legal forensic cases and engagements?

Forensic nursing combines the traditional nursing process with the
principles of forensic science and criminal justice when caring for the
most vulnerable--victims of violence; investigating legal matters;
evaluating product tampering and liability; leading death
investigations; and investigating child and elder abuse, custody
matters, and domestic violence and trauma.

There are many sub-specialities within forensic nursing, which
allow for a multi-disciplinary approach and collaborative practice in
which knowledge and responsibility are shared in order to reach common
goals.

Specialities include:

Sexual Assault Nurse Examiner (SANE)

Domestic Violence Forensic Nurse

Forensic Pediatric Nurse

Forensic Nurse Examiner

Nurse Death Investigator

Forensic Psychiatric Nurse

Forensic Clinical Nurse Specialist

Forensic Nurse Educator/Researcher

Nurse Attorney

Police Nurse

Forensic Geriatric Nurse

Legal Nurse Consultant

Nurse Coroner

Forensic Nurse Consultant

Correctional Nurse

Disaster Response

The common thread for all forensic nursing sub-specialities
includes specialized education and experience, conducting research in
their area of expertise to substantiate evidence-based care, testifying
in legal matters, identifying and evaluating injuries for all types of
crimes and all patient populations, and taking care of legal and
healthcare needs.

Forensic nurses, based on expertise and specialized knowledge,
benefit the patient populations they serve in the following ways:

* recognizing and caring for vulnerable populations, including
those who are incarcerated or mentally ill, abused or neglected
children, the elderly, or victims of intimate partner violence

* dealing with hazards in the workplace including equipment,
toxins, and violence.

Supporting the community is also an essential role of forensic
nurses. They educate other healthcare professionals based on identified
community health needs, risks, or crime data. Forensic nurses also
benefit the legal community by serving as liaison between healthcare and
the justice system. They bridge the gap between nursing and law
enforcement with their ability to collect and preserve evidence in the
following ways:

* gather critical information and evidence based on clinical
assessment.

* identify injuries from weapons or human abuse.

* interview patients to evaluate method and mode of injury.

* determine whether injury or death can have forensic implications.

* testify to the medical findings and evidence collected.

What are some of the focal points of the Introduction to Forensic
Nursing course?

Introduction to Forensic Nursing allows nurses to investigate the
application of forensic principles and standards of care while
integrating this contemporary science into traditional healthcare.
Meeting the healthcare and legal needs of vulnerable populations and
victims of violence through the lifespan is explored with prevention and
intervention as the focus. Topics include assessment and interview
strategies with consideration of physical and cognitive limitations, age
specific needs, gender-related concerns, and ethnic- and
cultural-specific risk factors. Red flags and warning signs of school
violence as well as individual and community strategies to prevent youth
violence are evaluated. Physical, emotional, and psycho-social
implications of children witnessing acts of domestic violence are
explored. Wound and injury identification is included to provide an
in-depth comparative focus on traumatic wounds indicative of abuse,
self-inflicted injuries, and anticipated, age-specific injuries. Cause,
manner, and mechanism of death are examined in relationship to working
with the coroner's office. Documentation skills and evidence
collection techniques are enhanced while learning about individualized
examination techniques, forensic terminology, body maps, and
photographic techniques that are the best practice. This course
evaluates the role of the forensically trained nurse in the courtroom
and with law enforcement as supported by ethical, legal, and moral
principles that guide daily practice and lifelong commitment to our
patients, the victims of violence.

What is the significance of a CFN designation and how will earning
this designation set someone apart from other nursing professionals?

The Certified Forensic Nurse certification credential is an
important indicator to patients, employers, the public, and other
professional colleagues that the certified nurse is qualified,
competent, and current in this nursing specialty. Certified Forensic
Nurses have met rigorous requirements to achieve this expert credential.

To become a Certified Forensic Nurse, CFN[R], a candidate must meet
all eligibility criteria as established by the ABFN and ACFEI. CFN
candidates must submit the completed CFN application form and payments,
then successfully pass the certification examination. For more
information, call us at (800) 423-9737 or check out www.acfei.com